Case Study: Pathogenesis of Pneumonia & Sepsis in a 75-Year-Old

This case study examines the pathogenesis of community-acquired pneumonia and subsequent sepsis in a 75-year-old male, Mr. Farouq. The analysis focuses on the systemic inflammatory response syndrome (SIRS) criteria met by the patient, including elevated temperature, heart rate, and white blood cell count, leading to septic shock. It discusses the inflammatory and coagulatory processes contributing to endothelial dysfunction and microvascular thrombosis. The study outlines key nursing interventions, such as monitoring vital signs, administering corticosteroids and vasopressors, and managing airway clearance, alongside rationales for each. Finally, it interprets arterial blood gas results, revealing metabolic and respiratory acidosis linked to sepsis and lung infection, highlighting the importance of monitoring acid-base balance. Desklib offers a wealth of similar solved assignments.

Running head: PATHOGENESIS ASSIGNMENT
Pathogenesis assignment
Name of the student:
Name of the university:
Author note:

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PATHOGENESIS ASSIGNMENT
Table of Contents
Question 1: 3
Question 2: 3
Question 3: 5

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PATHOGENESIS ASSIGNMENT
Question 1:
This assignment has chosen the case study of Mr Farouq, a 75 year old man who had been
presented to the health care facility with community acquired pneumonia. The patient started
suffering with shortness of breath in the facility and the diagnosis had been pneumococcal
pneumonia with severe sepsis as exacerbation. Now it had to be mentioned that sepsis or septic
shock can happen at any point during as infection, and it is preceded by systemic inflammatory
response (SIRS). According to the research, sepsis is the deadly response of the body to infection
and the mechanism of the response is through SIRS which plays a critical role in the
pathophysiology of sepsis. The occurrence of SIRS is facilitated by a few key changes’; in case
of the patient the key changes that were visible include body temperature higher at 39 degrees,
high heart rate at 128 beats per minute and higher blood cell counts. According to the American
College of Chest Physicians/Society of Critical Care Medicine Consensus Conference, as the
patient met the above mentioned three criteria, it can be mentioned this had been the
pathophysiologic course behind the septic shock. When SIRS is accompanies by infection,
inflammation, coagulation and fibrinolysis occurs soon after which then leads to endothelial
dysfunction and microvascular thrombosis; the entire phenomenon leads directly to sepsis.
Question 2:
The intervention strategies as per the care priorities include:
Nursing diagnosis Intervention Rationale
Risk for shock and
severe sepsis
Monitoring the heart rate and blood
pressure of the patent along with the
Diligent monitoring and
assessment will be helpful in
discovering and addressing

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PATHOGENESIS ASSIGNMENT
temperature.
Administration of corticosteroids
(prednisone), histamine 2 receptor
blockers (famotidine, cimetidine),
vasopressins (norepinephrines,
dopamines)
further exacerbation.
Corticosteroids will help in
reducing capillary permeability,
enhancing renal perfusion, and
restricting microemboli
formation.
Ineffective airway
clearance and impaired
gas exchange resulting
into shortness of
breath.
Monitoring the respiratory rate of the
patient and auscultation of breathing
sounds.
Performing tracheal suction for sputum
collection of the patient.
Administering medications such as
mucolytics, expectorants,
bronchodilators, analgesics.
Elevating the bed and changing the
position of the patient to recovery
position and provide a calm environment.
It will help in understanding and
addressing the needs of the
patient effectively.
It will help in facilitating better
airway exchange of the patient
and will enhance the oxygen
saturation.
It will help in reducing the
frequency of bronhospasms and
will facilitate mobilization of the
secretions.
Will relax the patients and
recovery position will aid in
respiratory muscle use burden.

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PATHOGENESIS ASSIGNMENT
Question 3:
Arterial blood gases can be considered as very important routine investigation in order to
monitor acid base balance of the patient. In this case, the blood pH of the patient is at 7.24
which is lower than the normal range. The pathophysiology behind this is the metabolic
acidosis facilitated by sepsis and risk for multiple organ failure. The paCO2 is higher than the
normal range which coupled with high pH indicates at the underlying process of respiratory
acidosis; which is facilitated by intrinsic lung infection, sepsis and induced trauma and pain
on the patient. The PaO2 lower than the normal range and the underlying pathophysiology in
intrinsic lung infection leading to reduced capacity of the respiratory muscles and decreased
oxygen saturation. HCO3 and BE is within normal ranges of the patient, however lactate
accumulation is high in the patient due to raised anion gap metabolic acidosis due to the
septic shock and infection.